Medical News Today: Nicotine withdrawal symptoms and how to cope

When nicotine starts to leave the body after smoking tobacco, people experience physical and psychological withdrawal effects.

Nicotine is the addictive substance found in tobacco products, such as cigarettes and cigars. It is a drug that can affect a person’s brain function.

Once the body adapts to regular nicotine intake, people find giving up smoking difficult because of the uncomfortable symptoms of nicotine withdrawal.

Withdrawal symptoms usually peak after 1–3 days and then decrease over a period of 3–4 weeks. After this time, the body has expelled most of the nicotine, and the withdrawal effects are mainly psychological.

Understanding nicotine withdrawal symptoms can help people to manage while they quit smoking. This article will discuss nicotine withdrawal, including its symptoms and tips on how to cope with them.

What is nicotine withdrawal?

Nicotine withdrawal may cause low mood and anxiety.

Nicotine has a number of different effects on a person’s body.

When someone uses a nicotine product, such as a cigarette, they absorb the nicotine through the lining of their nose, mouth, and lungs. From these locations, it enters the bloodstream.

When nicotine reaches the brain, it activates areas concerned with feelings of pleasure and reward and boosts levels of a chemical called dopamine.

Nicotine also affects areas in the brain related to:

breathing

memory

appetite

heart rate

When people use nicotine for an extended period, it leads to changes in the balance of chemical messengers in their brain.

When a person stops using nicotine quickly, they disrupt this chemical balance and experience physical and psychological side effects, such as cravings and low mood.

Experts describe this disruption of brain chemicals as nicotine addiction, and it is part of the reason why people find it so difficult to reduce or quit smoking.

Symptoms of nicotine withdrawal

The symptoms of nicotine withdrawal are both physical and psychological.

The physical side effects only last for a few days while the nicotine leaves the body, but the psychological side effects can continue for much longer.

Though it may feel unpleasant, nicotine withdrawal has no health dangers related to it.

Timeline of nicotine withdrawal

A person may experience easier breathing while exercising after they quit smoking.

Each person has a different experience of nicotine withdrawal.

Some people may feel the physical side effects more strongly than others. Some will experience mild symptoms for a few days, whereas others may have intense cravings and symptoms that last several weeks.

Withdrawal symptoms set in between 4 and 24 hours after a person smokes their last cigarette. The symptoms peak around day 3 of quitting and then gradually subside over the following 3 to 4 weeks.

For some, the cravings can last longer than other symptoms, and familiar places, people, or situations where someone used to smoke can trigger them.

Two hours after the last cigarette, the body will have already removed around half of the nicotine. The levels of nicotine continue to drop for the next few days until it no longer affects the body.

Alongside the withdrawal symptoms, people will also begin to notice positive changes. These can be improvements in their sense of smell and taste, less coughing, and easier breathing, particularly when exercising.

Treating nicotine withdrawal

Quitting nicotine can be difficult because the addiction is both physical and psychological. Many people benefit from various kinds of support during the period of nicotine withdrawal.

Treatments for nicotine withdrawal include:

Nicotine replacement therapy

Nicotine replacement therapy (NRT) is where a person stops using tobacco and uses one of the following substances that contain smaller amounts of nicotine instead:

chewing gum

skin patches

inhalators

tablets

nasal or mouth sprays

There is no research to suggest that one method is more effective than another. Combining different types of NRT could have a stronger effect than a single method alone.

Research has found that using NRT can increase the chance of quitting by 50 to 60 percent. At this point, an individual can gradually reduce the dosage of nicotine until no further treatment is needed.

NRT is a common and successful treatment for nicotine withdrawal. However, many people will still experience certain withdrawal symptoms, which may be stronger in some individuals than others.

While side effects of NRT are possible, the withdrawal symptoms from nicotine without NRT can often be worse. Possible side effects of NRT include:

Medication

Several types of medication can help treat nicotine withdrawal, such as:

Varenicline: Under the brand name Chantix, this drug can reduce cravings and block the rewarding effects of smoking.

Bupropion: This medication is sold as Zyban, and people also use it as an antidepressant. More recently, it has been used to help reduce cravings.

E-cigarettes

Electronic cigarettes or e-cigarettes contain nicotine, which is consumed as vapor but does not contain the same host of harmful substances as most other tobacco products. E-cigarettes can be used instead of traditional tobacco products.

But the health risks of smoking e-cigarettes are not yet known. They may be less harmful than smoking tobacco cigarettes, but there is currently insufficient research to confirm this.

Counseling

Counseling can help some people cope with the psychological and physical aspect of nicotine withdrawal. It can be a valuable addition alongside NRT.

Counseling can help people to identify and address triggers that are preventing them from quitting.

People can see a therapist or join a support group.

Tips for coping

Taking up a hobby, such as journaling, may help distract from withdrawal symptoms.

People should remember that many craving will only last for 15–20 minutes. This means that when someone feels a craving coming on, they can distract themselves in some way until it passes.

Many people find the following tips and strategies can help them cope with nicotine withdrawal symptoms:

mentally preparing for the reality of withdrawal symptoms

making a list of the benefits of quitting, and rereading them when a craving hits

exercising more regularly during withdrawal, especially as a distraction from cravings

adding social pressure by telling people about their decision to quit

avoiding triggers, such as drinking alcohol or visiting specific places

being realistic about how long quitting can take

taking up new hobbies and keeping busy

spending more time with friends who do not use nicotine

Outlook

Nicotine withdrawal symptoms can be uncomfortable and may feel overwhelming at times, particularly in the first week. Some people relapse because of this or are afraid of trying to quit.

But many people successfully overcome the challenge of nicotine withdrawal because of the benefits of quitting. Sometimes it can take a few tries before a person kicks the habit for good.